2021-11-11T17:21:45-06:00 2020-12-31 990 2020-01-01 752890358 Texas Health Presbyterian Hospital Allen % DAVID JACKSON TEXA 9727471000 1105 Central Expressway North Allen TX 75013 David Jackson Assistant Secretary 6822367900 2020-11-11 David Jackson 999009999 2 2020 2022-09-23 18:48:47Z Jared Shelton 1105 Central Expressway North Allen TX 75013 97935999 false X texashealth.org X 2000 TX A faith-based organization whose mission is to improve the health of the people in the communities it serves regardless of their ability to pay. 16 13 485 85 0 30146 2980185 90150950 93426213 28364 -340787 488106 1430746 90697566 97496357 118187 115898 0 0 37726206 39309470 0 0 0 48452871 52724362 86297264 92149730 4400302 5346627 102331493 114290747 17841790 12904944 84489703 101385803 X A FAITH-BASED ORGANIZATION WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES REGARDLESS OF THEIR ABILITY TO PAY. false false 75660670 115898 94540904 Texas Health Presbyterian Hospital Allen ("THA") is an 62-bed acute care hospital serving the northern Collin County area since 2000. The hospital's services include emergency services, orthopedic care, back and spine, cardiac cath lab, electrophysiology, robotic surgical care, cardiac rehab, digestive health, wound care and women's services. The hospital recently completed a $68.0 million expansion that increased bed, Cath lab and operating room capacity and opened in June 2020. THA was designated as a Level 2 Neonatal Intensive Care Unit by the Texas Department of State and Health Services and an Accredited Chest Pain Center and Stroke Ready hospital by the Joint Commission. More than 380 employees work at this hospital, and more than 500 physicians are practicing on its medical staff. THA had 10,530 patient days, 2990 discharges, 341 births, 35,219 outpatient encounters, and 18,186 emergency room visits during the year. THA provides quality medical healthcare services regardless of the patient's race, creed, sex, national origin, handicap, age or ability to pay. THA provides care to persons covered by governmental programs, including Medicare and Medicaid, for reimbursement that does not always cover the cost of providing the care. THA also provides charity care to patients who are unable to pay for the services they receive. 75660670 true true false true false false false false false false true false false false true false false true false false false false false false false false true true true false true false false false false false false false false true false false false false true false false false true X 25 0 true 485 true false false false false false false false false false false false false X 16 13 true false false false true true true true true false false true true true true true true false false false X X DAVID JACKSON 6822367900 612 E LAMAR BLVD Arlington TX 76011 X BerdanBarclay E THR CEO/Trustee 0.32 44.68 X 0 3464659 69034 KramerKenneth J Assistant Secretary 0.5 40.0 X 0 1321719 59354 McWhorterRicky E Former Officer 0.0 40.0 X 0 1228517 67783 SchwabRobert Adams Chief Medical Officer THA 40.0 0.0 X 616352 0 71852 JacksonDavid W Assistant Secretary 0.5 40.0 X 0 527169 57564 ReecerJeffrey P Former Officer 0.0 40.0 X 0 432321 77712 AsturiElizabeth Former Officer 0.0 40.0 X 0 438221 21893 SheltonJared Christopher President THA 40.0 0.0 X 360732 0 87484 CantuStacy G Corporate Secretary 0.5 40.0 X 0 354328 61297 GildonLisa Grp Finan Officer THP-THA 16.0 24.0 X 0 315192 59484 SummersJohn Blue Chief Nursing Officer THA 40.0 0.0 X 267934 0 41600 KrejciJacque D Former Officer 0.0 40.0 X 0 206187 42234 KOLBETSHARON Former Officer 0.0 40.0 X 0 197483 44032 HornKin-Lai Y RN IV 40.0 0.0 X 163725 0 49098 HollandJenese Michelle PROF & SUPPORT SVCS OFFICER 40.0 0.0 X 175443 0 33363 AmayaChristopher Jules DIR PHARMACY 40.0 0.0 X 178440 0 29949 PecenkaMichelle Leann DIR NRSG MED SURG/ICU/ED 40.0 0.0 X 168821 0 34679 VargheseJainamma RN V 40.0 0.0 X 151206 0 30155 Vigness MD Richard M Trustee 0.02 1.41 X 0 21121 0 Siripurapu MD Ravi Trustee 0.02 1.41 X 0 12731 0 Stripling MD W Dennis Chair 0.02 1.41 X 0 0 0 Turner Wesley R Immediate Past Chair 0.02 1.41 X 0 0 0 Wilder Jr Charles John Vice Chair 0.02 1.41 X 0 0 0 Guyton Michael E Trustee 0.02 1.41 X 0 0 0 Haggar III Joseph M Trustee 0.02 1.41 X 0 0 0 Hunt Hunter L Trustee 0.02 1.41 X 0 0 0 Montgomery Lynn A Trustee 0.02 1.41 X 0 0 0 Nunez MD Ignacio Trujillo Trustee 0.02 1.41 X 0 0 0 Reeves Kenneth W Trustee 0.02 1.41 X 0 0 0 Tatum Stephen L Trustee 0.02 1.41 X 0 0 0 Washington Bernice J Trustee 0.02 1.41 X 0 0 0 Weeks DNP RN Susan Mace Trustee 0.02 1.41 X 0 0 0 Wynne James Y Trustee 0.02 1.41 X 0 0 0 2082653 8519648 938567 79 true true false AUSTIN COMMERICIAL INC 3535 TRAVIS ST STE 300 DALLAS TX 75204 Construction Service 14074979 TEXAS HEALTH RESOURCES 612 E Lamar Blvd ARLINGTON TX 76011 MGMT SERVICES 13209832 TEXAS HEALTH PHYSICIANS GROUP 9250 Amberton Pkwy DALLAS TX 75243 PHYSICIAN SERVICES 1053326 VANGUARD RESOURCES INC 6500 HWY 281 NORTH SPRING BRANCH TX 78070 HOUSEKEEPING 823879 WELLTOWER INC C/O HEALTHCARE PROPERTY PO BOX 7335 DALLAS TX 75373 MGMT SERVICES 790947 9 166026 2814159 68268 2980185 PATIENT REVENUE 622110 92792225 92792225 COST REPORT ADJ 622110 543853 543853 PERFORMANCE FEES 622110 52699 52699 EDUCATION 624190 25778 25778 MANAGEMENT FEE 622110 11658 11658 93426213 25836 25836 0 0 69598 69598 0 69598 69598 73019 439642 -366623 -366623 -366623 0 0 0 0 0 0 0 0 0 BUSINESS INTERRUPTION/OTHER INSURANCE 622110 1085589 1085589 CAFETERIA 722514 162554 162554 FITNESS CENTER 622110 48450 48450 64555 29102 35453 1361148 97496357 94540904 -24732 115898 115898 0 0 0 1445956 1445956 0 30414899 30290529 124370 1409176 1389655 19521 3812931 3812931 2226508 2154518 71990 13209832 13209832 960 960 0 0 0 0 8465376 8409617 55759 34821 27211 7610 221335 199655 21680 585945 534704 51241 0 1861053 1518568 342485 11068 5537 5531 0 28454 28408 46 1177891 1177891 0 7772755 6988445 784310 1126103 1126103 MEDICAL SUPPLIES 14077991 14076002 1989 LPPF IGT 1087076 1087076 REPAIRS & MAINTENANCE 874567 465419 409148 NON CAPITAL EQUIPMENT 821400 732452 88948 1367735 1519091 -151356 92149730 75660670 16489060 0 -6796 -13386 0 0 0 0 12339505 14271341 0 0 0 0 417710 356788 1476819 2233905 120938 192447 161770303 64519945 87982780 97250358 0 0 0 0 0 0 0 0 537 -706 102331493 114290747 13984844 7373427 0 0 1064842 2349618 0 0 0 0 0 0 0 0 0 0 2792104 3181899 17841790 12904944 X 84489703 101385803 0 0 84489703 101385803 102331493 114290747 X 5346627 11549473 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false true false false false false false false Schedule C, Part II-B - Additional Information Officers and/or Board Members of the corporation may, to an insubstantial degree, make comments or statements concerning legislation that may affect either the healthcare industry or the health status of the communities the Corporation serves. In pursuing this activity, Officers and/or Board Members may engage in conversations and/or write letters to various federal, state, and local officials regarding such matters on a personal level, and not as a representative of the organization. The amount of time and money involved in these activities is negligible. In no case has either the Corporation, or any person acting on behalf of the Corporation, intervened in any political campaign. 8903474 8903474 43948883 22976967 20971916 56958900 15929237 41029663 48906215 25613740 23292475 3052830 3052830 97250358 0 EST THIRD PARTY PAYOR SETTLEME 3181899 3181899 true true X true X true X 500. true true false true true 4497415 232742 4264673 0.04630 5159833 5366170 0 0.00000 31951 8001 23950 0.00030 9689199 5606913 4288623 0.04660 615120 0 615120 0.00670 224748 0 224748 0.00240 111132 0 111132 0.00120 23806 0 23806 0.00030 974806 0 974806 0.01060 10664005 5606913 5263429 0.05720 13806 0 13806 0.00010 60187 0 60187 0.00070 9459 0 9459 0.00010 83452 0 83452 0.00090 false 9898547 0 12181229 17359094 -5177865 X true true 1 1 Texas Health Allen 1105 Central Expressway North Allen TX 75013 www.texashealth.org TDH #7242 X X X Texas Health Allen 1 false false true X X X X X X X X X 19 true true false true X See Section C X true 20 true See Section C false true X 200. 500. X X X true true X X X true X See Section C X See Section C X See Section C X X X X X X true X false X X X X true X false false Texas Health Allen Part V. Section B, Line 3e The CHNA contains a prioritized description of the significant health priorities of the community as identified through the CHNA. Part V. Section B, Line 5 Texas Health Allen's (THA) 2019 CHNA was a collaborative process utilizing qualitative and quantitative methods to assess the health needs of persons within the service areas in the Collin County region. The 2019 CHNA was conducted at the Collin County regional level to generate community-driven solutions for better integration in addressing the clinical and social needs of individuals living in North Texas. Between April 2018 and August 2018, the communities' health needs were assessed through key informant interviews, secondary data analysis, a windshield survey serving to assist asset-mapping through community observation, and focus groups. Key informants and focus group participants included, but were not limited to faith community representatives, public health officials, lay community members, school officials and city administration. The organization engaged 22 community members with interests specific to the health of individuals in the Collin County region in the CHNA development process. Seventeen of these community members were engaged across two separate focus groups held in zip-codes that were identified as underserved areas. Five served as key informants, and the windshield survey was conducted by two Texas Health graduate fellows and three community health managers. To gain a comprehensive understanding of the health needs and priorities of individuals in this region, Texas Health used focus group sessions and key informant interviews to engage the medically underserved, low-income or minority populations along with representatives from the following community organizations: Allen Community Outreach; ARTA Travel; Cigna; City of Plano; Frisco Chamber of Commerce; Iconic Consulting Group, Inc.; Northbridge Church; Plano ISD; Professional Office Services of Dallas; Texas Department of State Health Services; and Toyota Motor North America. Findings from all data sources (secondary data, interviews and focus groups, and the windshield survey/observational asset mapping) were compared. Recurring themes were pulled and analyzed to stratify the top medical and social determinant of health needs. The outlined needs/barriers impacted the development of the 2020 CHNA implementation plan, which leveraged integrated strategies across THR's internal and external stakeholders to enhance its service and program delivery in the target communities. Part V. Section B, Line 6a The 2019 CHNA for the Collin County Region was done in collaboration with Texas Health Frisco (THF), Texas Health Plano (THP), Texas Health Allen (THA) and Physicians Medical Center (PMC). Part V. Section B, Lines 7a and 10a The most recently adopted implementation strategy and the CHNA is widely available on the following website: https://www.texashealth.org/Community-Health/Community-Health-Needs-Assess ment Part V. Section B, Line 11 The 2020 - 2022 implementation strategy focused on reforming the delivery of our services in the target communities. The hospital is part of the Texas Health Resources (THR) healthcare system, which developed a system-wide community benefit strategy to increase its hospitals' ability to impact the community health needs of the target areas with a higher focus on three health priorities. Through the prioritization process these three health priorities from the 2019 CHNA were determined to be ongoing issues that THR hospitals needed to address: 1. Behavioral Health 2. Chronic Disease Prevention & Management 3. Access to Health Services and Healthcare Navigation & Literacy In 2020, Texas Health Allen addressed significant health needs with the following approaches: 1. Behavioral Health 1a. Through an RFP process by Texas Health Resources through its Texas Health Community Impact (THCI) Initiative, two organizations were awarded grants to address the impact of depression and increase access to social services in specific zip-codes designated as high-need populations. Collin County MHMR dba LifePath Systems was awarded a grant to implement the project titled Beyond Blue: Life Begins at 55 - depression shouldn't. In collaboration with the Community Health Center of McKinney, Community Lifeline Center, Hope Clinic of McKinney, McKinney Roots, and Wellness Center for Older Adults, the project helps senior adults facing chronic disease, isolation, and depression. Upon follow-up screenings, depression severity had decreased in many individuals. Through Beyond Blue, individuals were: -screened for depression, -enrolled in counseling, -navigated to case management services, -received meal assistance, -received transportation assistance, Plano Education Foundation was awarded a grant to implement an effort called PlanoUP!, a collaboration to provide centralized services that address depression and barriers to social determinants of health on school campuses in East Plano. Through PlanoUP!, the following was provided: -Students were navigated to available resources, -Plano ISD staff were trained in the administration of Youth Mental Health First Aid (Y - MHFA), -students received Y-MHFA skills training, and -mobile food pantry distributions were set up on school sites 2. Chronic Disease Prevention & Management 2a. Historically, Texas Health Resources has funded the work of local community health clinics in its mission to improve the health of the people in the communities served. The goal of Clinic Connect is to create a collaborative relationship with local non-profit community-based clinics by providing financial support, educational opportunities, information sharing, and expanded services to improve healthcare access and quality for underserved and vulnerable populations. The Clinics receiving funds are required to report on specific process and outcome measures, including average wait time for appointments, percentage of diabetic patients whose A1c levels were improved, and percentage of patients whose blood pressure were controlled based on the management/treatment guidelines. In 2020, the hospital awarded a grant to the Children and Community Health Center (CCHC) of McKinney. This funding contributed to CCHC's ability to serve patients and report clinical outcomes of improved A1C levels and improved blood pressures. 2b. With heart disease and cancer still being the leading cause of death. The hospital collaborated with the American Heart Association to provide heart disease workshops in their surrounding community. 3. Access, Literacy, and Navigation 3a. Health Workshops 3a1. Child Automobile Safety Initiative (CASI) is a program focused on protecting children from injury in motor vehicle collisions by providing free car seat safety checks and community-based education. 3a2. The faith community nurses provided shots to local parishes and city residents. 3a3. The hospital provided free blood screenings and interpretations of the results to City of Allen employees. All the priority health needs identified are being addressed by this hospital as listed above. Part V. Section B, Line 13 h Although a patient may have been notified of the Financial Assistance Policy, there are times when the patient chooses not to complete the Financial Assistance Application. Texas Health routinely screens uninsured patients using an independent third party for financial assistance eligibility. Part V. Section B, Lines 16 a, b & c The FAP, FAP Application and the Plain Language Summary of the FAP were widely available at this website: https://www.texashealth.org/About-Texas-Health/Insurance-and-Costs/Financi al-Assistance Texas Health Allen Part I, Line 3c - Patient Eligibility Patients with family income at or below 200% of applicable Federal Poverty Guidelines (FPG) may be eligible for free care if the patient lacks sufficient funds and assets to pay the out-of-pocket portion of their hospital bill. Patients with a family income above 200% of applicable FPG who have unpaid medical bills exceeding a specified percentage of the patient's annual gross income, as determined on a sliding scale based on FPG, may be deemed medically indigent and eligible for charity care. The patient may be eligible for a charity adjustment up to 100% of the unpaid balance of their hospital bill in excess of a specified patient responsible amount if the patient has insufficient funds/assets to pay his hospital bill without incurring an undue financial hardship. The patient responsible amount is based on a percentage of the patient's annual income in relation to FPG. A determination as to whether or not a patient has insufficient funds and/or assets to pay for purposes of determining both financial and medical indigence is made at the time a patient's financial assistance application is reviewed. Assets considered when determining eligibility include cash, stocks, bonds and other financial assets that can be readily converted to cash. An additional process to screen for charity patients using publicly available financial information is also in place for patients not submitting a financial assistance application. Part I, Line 7 - Cost-to-Charge Ratio A cost-to-charge ratio is used to compute the amounts reported on Lines 7a-7c. The cost-to-charge ratio is derived from Worksheet 2 - Ratio of Patient Care Cost-to-Charges, as found in the Schedule H Instructions. The amounts reported on Lines 7e-7i were computed using direct costs, as determined by a cash outlay. Part II - Community Building The organization participates in community building activities that aim to address the socio-economic factors that influence the overall health of individuals in the communities served. As identified in the community health needs assessment, there are areas of need that are not in alignment with the operations of a hospital system. Our volunteerism, collaborations and partnerships with various help organizations and various area coalitions help in addressing the socio-economic factors that are the backbone for many underlying health concerns. Part III, Lines 2, 3 & 4 - Bad Debts Bad debt expense is not included for purposes of reporting community benefits. Each patient qualifying for charity care is treated as a charity patient and no charges related to that patient are included in bad debt expense. The hospital is part of a consolidated system of hospitals which operate under the name Texas Health Resources (THR). THR's annual audit is conducted on a system-wide basis with a single consolidated audit report issued for THR and its affiliates. The audited financial statements of THR, which includes the activity of the organization, contain a footnote regarding Accounts Receivable and Net Patient Service Revenue that reads as follows: Patient service revenue is reported at the amount that reflects the consideration to which the System expects to be entitled in exchange for providing patient care. Healthcare services promised in the contract with a patient represent a bundle of goods and (or) services that is distinct and accounted for as a single performance obligation. The transaction price for the bundled goods and (or) services provided is estimated by reducing the total standard charges by variable price concessions, including contractual adjustments based on the terms provided by (in the case of Medicare and Medicaid) or negotiated with (in the case of managed care and commercial insurance companies) third-party payors, the System's discount policies, and other implicit price concessions based on historical collections experience for uninsured and under-insured patients who do not qualify for financial assistance. A portfolio approach by major payor categories and types of service is used to estimate the historical collections experience. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. Portfolio collection estimates are updated at least quarterly based on actual collections experience. The System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach was used. Under THR's financial assistance policy, the Tax-Exempt Hospitals, Texas Health Rockwall, and Texas Health Physicians Group provide care to patients without charge or at amounts less than their established rates if the patient meets certain established criteria. The consolidated joint venture hospitals and healthcare entities have similar financial assistance policies, or have adopted the THR financial assistance policy. As the System does not pursue collection of amounts determined to qualify as financial assistance, those amounts are not reported as patient service revenue or patient accounts receivable. Revenue related to providing care to patients is recognized as the performance obligation is satisfied over the period of time the patient is receiving treatment, as the patient is simultaneously receiving and consuming the benefits provided by the System. The performance obligation is generally satisfied over an average period of less than five days for inpatient services and one day for outpatient services. Generally, patients and third-party payors are billed within days after the services are performed and (or) the patient is discharged. The transaction price related to unsatisfied or partially unsatisfied performance obligations at the end of the reporting period primarily relate to inpatient acute care services for patients who remain admitted at that time (in-house patients). As of December 31, 2020 and 2019, contract assets of $49,827 and $33,617, respectively, were recorded in patient accounts receivable on the consolidated balance sheets. Patient accounts receivable is reported at the amount that reflects the consideration to which the System expects to be entitled in exchange for providing patient care. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance company has paid the amounts covered by the applicable agreement, but patient responsibility amounts remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients based upon management's assessment of historical write-offs and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Patient accounts are monitored and, if necessary, past due accounts are placed with collection agencies in accordance with guidelines established by management. Accounts are written off when all reasonable internal and external collection efforts have been performed. Estimated implicit price concessions of $366,511 and $437,785 were recorded as reductions to patient accounts receivable at December 31, 2020 and 2019, respectively, on the consolidated balance sheets. Part III, Line 8 - Medicare Shortfall The state of Texas treats any Medicare shortfall as a community benefit for meeting the state statutory requirements for charity care & community benefit. For state purposes, the shortfall is computed by comparing actual Medicare reimbursements with the estimated cost the hospital incurs in providing these services to Medicare patients. Cost is determined by applying a cost-to-charge ratio (with costs determined in accordance with generally accepted accounting principles) to billed charges. The shortfall amount reported to the state of Texas for 2020 is $5,181,430. Sch H requires a different method to calculate the Medicare shortfall shown on Part III, Lines 5-7. Part III, Line 9b - Debt Collection During the year, standard collection procedures were in place and uniformly applicable to all patient accounts. Except to the extent a patient receives a recovery from any third party or other source, no attempts are made to collect unpaid charges from patient accounts approved for adjustment under the Financial Assistance Policy. Part VI, Line 2 - Needs Assessment In 2019, Texas Health Resources (Texas Health) completed a community health needs assessment (CHNA) for 25 facilities across 5 regions through the following steps: - Demographic analysis by region - Secondary data analysis of health indicators to identify zip codes of highest-needs within each region - Community input data collection and assessment via key informant interviews, focus groups, and a windshield survey - Synthesis of secondary data and community input data to identify most pressing health needs by region - Prioritization of zip codes with im true DALLAS SAFETY NET SUPPORT CORPORATION 1441 N BECKLEY AVE DALLAS TX 75203 823131059 501(c)(3) 25362 INDIGENT Health CARE ALLEN COMMUNITY OUTREACH 801 E MAIN STREET ALLEN TX 75002 751986190 501(c)(3) 20000 General Purpose CITY OF ALLEN 305 CENTURY PARKWAY ALLEN TX 75013 756004912 City of Allen 20000 General Purpose ALLEN CHAMBER OF COMMERCE 210 W MCDERMOTT DR ALLEN TX 75013 751876471 501(c)(6) 9000 GENERAL PURPOSE Allen Sports Association 950 E MAIN STREET Allen TX 75002 752253580 501(c)(3) 10000 General Purpose Allen ISD 612 E BETHANY DRIVE ALLEN TX 75002 756000023 ALLEN ISD 25000 SPONSORSHIP 5 1 Schedule I, Part II - Monitoring Grants Texas Health Allen (THA) is a member of the Texas Health Resources (THR) healthcare system. The majority of the grants distributed by the system are to related tax exempt organizations. The hospital does not specifically monitor the use of grants paid to related organizations since THR administration monitors the use of these grants on a system basis for all members of the THR healthcare system. Grants to non-related tax exempt organizations are generally given to entities that are in the hospital's community and/or service area or to certain organizations which will specifically impact the hospital's community. These grants are typically monitored by hospital personnel who are working closely with the non-related nonprofit organization. X true true false true false false false false false false false BerdanBarclay E THR CEO/Trustee 0 1669945 0 1204331 0 590383 0 21375 0 47659 0 3533693 0 155068 KramerKenneth J Assistant Secretary 0 607963 0 303980 0 409776 0 21375 0 37979 0 1381073 0 46912 JacksonDavid W Assistant Secretary 0 320715 0 133061 0 73393 0 21375 0 36189 0 584733 0 11705 CantuStacy G Corporate Secretary 0 252447 0 70948 0 30933 0 12693 0 48604 0 415625 0 188 SchwabRobert Adams Chief Medical Officer THA 358130 0 167083 0 91139 0 21375 0 50477 0 688204 0 14019 0 SheltonJared Christopher President THA 215812 0 101818 0 43102 0 44617 0 42867 0 448216 0 11813 0 SummersJohn Blue Chief Nursing Officer THA 177754 0 65088 0 25092 0 8682 0 32918 0 309534 0 4152 0 GildonLisa Grp Finan Officer THP-THA 0 232572 0 52161 0 30459 0 15002 0 44482 0 374676 0 0 ReecerJeffrey P Former Officer 0 279517 0 83215 0 69589 0 21375 0 56337 0 510033 0 15608 KrejciJacque D Former Officer 0 186212 0 17742 0 2233 0 13561 0 28673 0 248421 0 0 AsturiElizabeth Former Officer 0 308918 0 85157 0 44146 0 21375 0 518 0 460114 0 10867 McWhorterRicky E Former Officer 0 746375 0 335698 0 146444 0 21375 0 46408 0 1296300 0 39816 KOLBETSHARON Former Officer 0 178482 0 17278 0 1723 0 8297 0 35735 0 241515 0 0 AmayaChristopher Jules DIR PHARMACY 158361 0 8345 0 11734 0 13035 0 16914 0 208389 0 0 0 HollandJenese Michelle PROF & SUPPORT SVCS OFFICER 165608 0 9240 0 595 0 3714 0 29649 0 208806 0 0 0 PecenkaMichelle Leann DIR NRSG MED SURG/ICU/ED 148300 0 8072 0 12449 0 1614 0 33065 0 203500 0 0 0 HornKin-Lai Y RN IV 154521 0 720 0 8484 0 12594 0 36504 0 212823 0 0 0 VargheseJainamma RN V 147737 0 1220 0 2249 0 11336 0 18819 0 181361 0 0 0 Schedule J, Part I, Line 1a - Discretionary Spending Account EACH EXECUTIVE AT THE VICE PRESIDENT LEVEL AND ABOVE RECEIVES A PERK ALLOWANCE WHICH IS INCLUDED IN THE TAXABLE COMPENSATION OF THE EMPLOYEE. This allowance covers costs such as business use of their personal vehicles in lieu of reimbursement for auto mileage. It also allows access to certain executive benefits including individual long term disability, long term care and individual life insurance. Schedule J, Part I, Line3 - CEO Compensation The organization relied on Texas Health Resources (THR), a related 501(c)(3) organization with centralized compensation professionals to use the following methods to establish the Compensation of the organization's President. *The Compensation committee (which includes independent persons) performs reviews and makes recommendations to the THR Board. *An Independent compensation consultant may be hired. *Compensation surveys or studies are utilized. *Approval by the Board or Compensation committee is required. Sch J, Part I, Line 4b Nonqualified Retirement Plan Participation in the plan is made available to a select group of management and highly compensated employees as determined by the THR Board of Trustees, who are providing services in a key position of management and responsibility. For the active restoration account (Account balances after 12/31/2009) SERP benefits vest while the participant is employed if the participant: * Reaches age 65 * Becomes disabled or dies, * Reaches the following years of service: 2 Years - 25%; 3 Years - 50%; 4 Years - 75% and 5 or more years - 100% Participants must be employed on Dec 1 to qualify for the current year's SERP Benefit unless separation is due to death, disability, retirement (Age 65) or early retirement (separation from service at or after age 55 with 75 years of combined age and service with the system.) SERP benefits are calculated each Dec 1. Vested balances are taxed to the employee and the net balances begin accruing earnings. Vested balances are paid in a cash lump sum within a 90-day period commencing on the earlier of death, disability, or separation from service. The deferred portion is included in Schedule J, Part II, column C. In frozen restoration accounts (account balances prior to 1/1/2010), the participant or beneficiary shall be taxed on his or her vested SERP benefits upon the earliest of: * Continued employment in THR until age 68 * Termination of employment for disability or death * Involuntary termination of employment without reasonable cause; or * Satisfying a 24 month non-compete period following his/her termination of employment. Payment follows the before mentioned events, except in the case of involuntary separation when the participant must wait 24 months to receive the previously taxed benefit. Payouts to the following employee were made during the year. The amounts below are included in the amount reported on Sch J, Part II, Column B(iii) and Column (F). Elizabeth Asturi $ 10,867 Berdan Barclay $155,068 David Jackson $ 11,705 Kenneth Kramer $ 46,912 Rick McWhorter $ 39,816 Jeff Reecer $ 15,608 Robert Schwab $ 14,019 Jared Shelton $ 11,813 John Summers $ 4,152 X 40 66628 non cash X MISCELLANEOUS 2 1640 NON CASH 0 false false false 990, Part V, Line 1a - Number reported in Box 3 of Form 1096 The taxpayer is a part of a healthcare system who recently adopted a new accounting system. As part of the change to the new accounting system, all Form 1099 filings were centralized under the parent, Texas Health Resources (THR). This is part of the system's efforts toward overall centralization of vendor relations and other shared services. THR bills its subsidiaries for management services. In some instances, the new accounting system was implemented at some point during the year. In these cases, the payments made to vendors captured under the old accounting system were processed by the entity under their own, individual FEIN. As a result, the number of Form 1099 filings reportable by the entity are significantly lower than in prior years since they are reporting for only a portion of the year. This does not reflect a change in operations, but merely a change in how the entity captures and pays its contractors/vendors. 990, Part VI, Section A, Line 2 - Business Relationship Texas Health Resources (THR) and its related organizations included in the THR healthcare system encourage employees to become involved in philanthropic endeavors in their communities. As a result, THR healthcare system employees who are serving as officers, board members, or key employees may, from time to time, also serve on the boards of various community organizations such as church boards, United Way, etc. There may be a business relationship as a result of multiple THR employees serving on the same community boards. THR employees serve as the corporate officers of each subsidiary organization. As THR system employees, all officers have a business relationship within the organizations of the THR healthcare system. THR also appoints system officers to the boards of various controlled joint ventures. As THR system employees, various officers of the organization may have a business relationship through serving on THR controlled joint venture boards. 990, Part VI, Section A, Line 6&7a - Members Texas Health Resources (THR) is the sole member of the organization. 990, Part VI, Section A, Line 7b - Governance Decisions Reserved The following actions require the approval of Texas Health Resources (THR): (a) Amendment, restatement or repeal of the Certificate of Formation or these Bylaws. (b) Sale, exchange, lease or other transfer of all or substantially all of the assets of the Corporation. (c) Merger or consolidation of the Corporation. (d) Dissolution of the Corporation. (e) Election of members of the Board of Trustees (f) Removal of a member of the Board of Trustees (g) Creation of affiliates or subsidiaries and approval of the initial governing documents. (h) Incurrence of debt not included in the budgets. (i) Discontinuing the operations of a licensed health care facility controlled by the corporation. (j) Activities involving winding up, distribution, conversion or exchange under Chapter 11 990, Part VI, Section B, Line 11b - Form 990 Filing The Texas Health Resources (THR) tax department staff prepares the Forms 990 for THR and all of its wholly controlled affiliates. In order to accurately prepare the returns, the tax staff works closely with various other departments to gather and review the information needed to complete the return. The departments involved in this process include, but are not limited to accounting, finance, treasury, human resources, payroll, legal, governance, and corporate compliance. The returns are then reviewed twice within the tax department before being given to the Financial Reporting department to review and to ensure that the financial information is accurate and up to date. All THR System Forms 990 are provided to members of the Audit and Compliance Committee of the THR Board, giving them an opportunity to review, comment and ask questions regarding the Forms 990. The tax department Vice President provides an overview presentation to the committee highlighting various areas of the Form 990. A resolution to approve all of the returns is voted upon at this meeting. Once the Audit and Compliance Committee has approved the returns, each return is then reviewed and signed by the Chief Accounting Officer/Assistant Secretary. The members of the governing Boards are provided a copy of the Form 990 for their respective entity before the Form 990 is filed. 990, Part VI, Section B, Line 12c - Conflict of Interest Texas Health Resources (THR) has adopted a Conflict of Interest Policy that applies to THR and all of its wholly owned or wholly controlled affiliates. During the first quarter of each fiscal year, a Duality and Conflict of Interest Statement Form is distributed by the THR Chief Compliance Officer to all board members, officers, contracted medical directors, employees with a title of manager or above, employed physicians, and certain committee members and other employees based upon function. All disclosed conflicts are reviewed by the THR Chief Compliance Officer. A report, listing each reported Duality of Interest or Conflict of Interest is given to both the Chair of the Governing body and the President of the Corporation with which the reporting person is affiliated. The THR Board of Trustees receives a report when the Annual Disclosure process is complete. Progressive corrective action is taken for any identified noncompliance which may include removal from a board or committee or physician/employee counseling if the person fails to provide the disclosure. In addition, THR monitors physician payments through a public database implemented by CMS. Management plans are executed as needed based upon disclosures. THR also educates the Boards and workforce annually through either a web based or live compliance training. 990, Part VI, Section B, Lines 15a&b - Compensation Determination The organization relied on Texas Health Resources (THR) with centralized compensation professionals to review and establish the compensation of the organizations officers. A more in-depth discussion of executive compensation review can be found on Schedule J, Part III. 990, Part VI, Section C, Line 19 - Public Disclosure The organization does not make its governing documents or conflict of interest policy available to the public. The consolidated financial statements of Texas Health Resources (THR) are made available to the public on the website www.dacbond.com. Consolidated financial statements are posted to this website quarterly and the audited financial statements are posted annually. The financial statements of the wholly controlled affiliates of THR are not posted to the website nor are they generally made available to the public in any other manner. 990, Part XI, Line 9 - Other Changes in Net Assets Adjustment for Intercompany Transactions of a Controlled Group $11,549,473. The intercompany adjustment eliminated the receivable/payable balance as of the end of the year between Texas Health Resources (THR) and all wholly controlled tax-exempt entities included in the THR Healthcare System. The adjustment represents current year activity. The THR Healthcare System records all related transactions through the intercompany Receivable/Payable accounts for each entity. The types of transactions recorded in the Intercompany accounts include management fees charged by the parent organization, services purchased between related organizations, supplies purchased by a centralized purchasing department, daily cash sweeps and similar transactions. 990, Part XII, Line 2c - Consolidated Financial Statements Texas Health Resources (THR) prepares consolidated financial statements with its related entities. The THR Board appoints an audit and compliance sub-committee that assumes responsibility for oversight of the consolidated audit for all related entities. The related entities do not have a separate audit committee, but abide by the THR committee's oversight. There has been no change during the year in the organizations oversight selection process. 990 Part XII, Line 3b - Single Audit Act & OMB Circular A-133 During 2020, the taxpayer received federal grant payments related to care for uninsured patients with COVID. As part of the THR healthcare network, the hospital's grant receipts are included in the consolidated THR single audit for 2020. Individually in 2020, the hospital did not exceed the $750,000 grant proceeds threshold that would require a separate single audit at the hospital level. Huguley Medical Assoc Inc 11801 South Freeway Burleson TX 76028 752547668 Phys Clinic TX 501(c)(3) 3 TH Huguley false North Texas Healthy Communities 612 E Lamar Blvd Arlington TX 76011 464513182 Comm Support TX 501(c)(3) 7 TH Resources false Southwestern Health Resources JOC 5323 Harry Hines Blvd Dallas TX 75390 811575989 Mgmt Org TX 501(c)(3) 12b TH Resources false Texas Health Arlington Memorial Hospital 800 West Randol Mill Rd Arlington TX 76012 750972805 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Back Care 9250 Amberton Pkwy Dallas TX 75243 474724257 Phys. Clinic TX 501(c)(3) 10 TH Phys Grou false TX Hlth Behavioral Hlth Hospital Bedford 2717 Tibbets Dr Bedford TX 76022 812798838 Inactive TX 501(c)(3) 3 TH Resources false TX Hlth Behavioral Health Hospital Plano 6110 W Parker Road Plano TX 75093 812792484 Inactive TX 501(c)(3) 3 TH Resources false Texas Health Alliance 10864 Texas Health Trail Fort Worth TX 76244 451502252 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Azle 108 Denver Trail Azle TX 76020 751748586 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Cleburne 201 Walls Dr Cleburne TX 76033 751977850 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Fort Worth 1301 Pennsylvania Ave Fort Worth TX 76104 756001743 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Hurst-Euless-Bedford 1600 Hospital Parkway Bedford TX 76022 751438726 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Southwest Fort Worth 6100 Harris Parkway Fort Worth TX 76132 752678857 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Stephenville 411 Belknap Stephenville TX 76401 751752253 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Frisco 12400 Dallas Parkway Frisco TX 75033 831954982 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Mansfield 2300 Lone Star Rd Mansfield TX 76063 831869297 Hospital TX 501(c)(3) 3 TH Huguley false Texas Health Huguley Inc 11801 S Freeway Burleson TX 76028 452694620 Hospital FL 501(c)(3) 3 TH Resources false Texas Health Huguley Surgery Center LLC 12001 S Freeway Burleson TX 76028 821289045 Amb Surg Ctr TX 501(c)(3) 3 TH Huguley false Texas Health Medical Support 612 E Lamar Blvd Arlington TX 76011 812833150 Spec Drugs TX 501(c)(3) 10 TH Resources false TX Health Outpatient Surg Ctr Alliance 10840 Texas Health Trail Fort Worth TX 76244 800800294 Inactive TX 501(c)(3) 3 TH Alliance false Texas Health Physicians Group 9250 Amberton Pkwy Dallas TX 75243 752613493 Phys. Clinic TX 501(c)(3) 10 TH Resources false Texas Health Allen 1105 Central Expressway N Allen TX 75013 752890358 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Dallas 8200 Walnut Hill Ln Dallas TX 75231 751047527 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Denton 3000 North Interstate 35 Denton TX 76201 432008974 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Kaufman 850 Ed Hall Drive Kaufman TX 75142 752771437 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Plano 6200 W Parker Rd Plano TX 75093 752770738 Hospital TX 501(c)(3) 3 TH Resources false TH Recovery and Wellness Center 240 Miller Road Mansfield TX 76063 812813227 Resd Trmt Ctr TX 501(c)(3) 3 TH Resources false TX Health Research & Education Institute 612 E Lamar Blvd Arlington TX 76011 752562191 Edu& Research TX 501(c)(3) 4 TH Resources false Texas Health Resources 612 E Lamar Blvd Arlington TX 76011 752702388 System Mgmt TX 501(c)(3) 12c NA false Texas Health Resources Foundation 612 E Lamar Blvd Arlington TX 76011 752022128 Fundraising TX 501(c)(3) 7 TH Resources false TH Specialty Hospital Fort Worth 1301 Pennsylvania Ave Fort Worth TX 76104 751648589 LT Hospital TX 501(c)(3) 3 TH Resources false TX Health Urgent Care 3805 W University Park 100 McKinney TX 75071 814317635 Urgent Care C TX 501(c)(3) 3 TH Resources false WW Ward Endowment Fund Trust 612 E Lamar Blvd Arlington TX 76011 756196065 Nursing Grant TX 501(c)(3) 12a TH Foundatio false AMH Cath Labs LLC 811 Wright St Arlington TX 76012 203003947 Hospital TX NA N/A 0 Arlington Surgery Center LLC 918 N Davis Dr Arlington TX 76012 752055800 Amb Surg Ctr TX NA N/A 0 Cleburne Surgical Center LLC 2010 W Katherine P Raines Blvd St Cleburne TX 76033 203742012 Amb Surg Ctr TX NA N/A 0 Denton Surgery Center LLC 207 North Bonnie Brea Denton TX 76201 470926556 Amb Surg Ctr TX NA N/A 0 Flower Mound Hospital Partners LLC 4400 Long Prairie Rd Flower Mound TX 75028 260684968 Hospital TX NA N/A 0 Fort Worth Endoscopy Centers LLC 900 W Magnolia Ave 101 Fort Worth TX 76104 770368346 Endoscopy Center TX NA N/A 0 Greenville Surgery Center LLC 7150 Greenville Ave Ste 200 Dallas TX 75231 742411643 Amb Surg Ctr TX NA N/A 0 Health Imaging Partners LLC 8610 Explorer Drive Ste 300 Colorado Springs CO 80920 271385885 Medical Imaging TX NA N/A 0 North Dallas Surgical Center LLC 17980 Dallas Pkw Ste 100 Dallas TX 75287 272248103 Amb Surg Ctr TX NA N/A 0 Opthalmology Surgery Center of Dallas LL 10740 N Central Expy Dallas TX 75231 261914835 Amb Surg Ctr TX NA N/A 0 Park Hill Surgery Center LLC 3455 Locke Ave Fort Worth TX 76107 451484375 Amb Surg Ctr TX NA N/A 0 Physicians Medical Center LLC 6020 W Parker Rd Plano TX 75093 481281376 Hospital TX NA N/A 0 Presbyterian Cancer Ctr-Dallas LLC PO Box 819067 Dallas TX 75381 260422749 Cancer Ctr TX NA N/A 0 Rockwall Regional Hospital LLC 3150 Horizon Rd Rockwall TX 75032 202848116 Hospital TX NA N/A 0 South Arlington Surgical Providers LLC 350 E Interstate 20 Ste 200 Arlington TX 76018 752723958 Amb Surg Ctr TX NA N/A 0 Southlake Specialty Hospital LLC 1545 E Southlake Blvd Southlake TX 76092 020555370 Hospital TX NA N/A 0 Surgical Caregivers of Fort Worth LLC 2001 W Rosedale St Fort Worth TX 76104 751925497 Amb Surg Ctr TX NA N/A 0 Texas Health Craig Ranch Surgery Center 8080 State Hwy 121 Ste 100 McKinney TX 75070 383897811 Amb Surg Ctr TX NA N/A 0 Texas Health Flower Mound Orthopedic Sur 5000 Long Prairie Rd Flower Mound TX 75028 800866449 Amb Surg Ctr TX NA N/A 0 Texas Health Orthopedic Surgery Center A 9848 N Beach St Fort Worth TX 76244 814977249 Amb Surg Ctr TX NA N/A 0 Texas Health Spine Surgery Center Allen 1120 Raintree Cir Ste 100 Allen TX 75013 300957868 Amb Surg Ctr TX NA N/A 0 Texas Health Spine Surgery Center Allian 1545 E Southlake Blvd Ste 100 Southlake TX 76092 320571301 Amb Surg Ctr TX NA N/A 0 Texas Health Supply Chain Services LLC 612 E Lamar Blvd Ste 600 Arlington TX 76011 841833532 Purchasing Co TX NA N/A -18594 Texas Health Surgery Center Alliance LLC 10840 Texas Health Trail Ste 100 Fort Worth TX 76244 822296081 Amb Surg Ctr TX NA N/A 0 Texas Health Surgery Center Bedford LLC 1605 Airport Freeway Ste 100 Bedford TX 76021 821307876 Amb Surg Ctr TX NA N/A 0 Texas Health Surgery Center Chisholm Tra 613 E Lamar Blvd Ste 600 Arlington TX 76012 843814491 Inactive TX NA N/A 0 Texas Health Surgery Center Irving LLC 2120 N MacArthur Blvd Ste 200 Irving TX 75061 831085415 Amb Surg Ctr TX NA N/A 0 Texas Health Surgery Center Preston Plaz 17950 Preston Road Ste 75 Dallas TX 75252 203991622 Amb Surg Ctr TX NA N/A 0 Texas Health Surgery Center Rockwall LLC 3144 Horizon Rd Ste 120 Rockwall TX 75032 474425996 Amb Surg Ctr TX NA N/A 0 Texas Health Surgery Center Southwest Fo 612 E Lamar Blvd Ste 600 Arlington TX 76011 843814490 Amb Surg Ctr TX NA N/A 0 Texas Health Surgery Center Waxahachie 1434 US Hwy 287 Bypass Ste 100 Waxahachie TX 75165 831464243 Inactive TX NA N/A 0 Texas Institute for Surgery LLP 7115 Greenville Ave Ste 100 Dallas TX 75231 770628004 Hospital TX NA N/A 0 THR-STT Rockwall ASC LLC 1545 E Southlake Blvd Southlake TX 76092 262429878 Amb Surg Ctr TX NA N/A 0 THR-STT Southlake ASC LLC 1545 E Southlake Blvd Southlake TX 76092 201728912 Amb Surg Ctr TX NA N/A 0 USMD Hospital at Arlington LP 801 I -20 West Arlington TX 76017 731662763 Hospital TX NA N/A 0 USMD Hospital at Fort Worth LP 5900 Altamesa Blvd Fort Worth TX 76132 203571243 Hospital closed TX NA N/A 0 Walnut Hill Surgery Center LLC 5494 Glen Lakes Dr Dallas TX 75231 364499777 Amb Surg Ctr TX NA N/A 0 Wilson Creek Surigcal Center LLC 8855 Synergy Drive McKinney TX 75070 274816583 Amb Surg Ctr TX NA N/A Women's Specialty Surgery Center of Dall 8230 Walnut Hill Ln Ste 101 Dallas TX 75231 262310072 Amb Surg Ctr TX NA N/A Grace Indemnity Company SPC Ltd 1159 Carribean Plaza Grand Cayman CJ KY 1-1102 981209573 Captive Insur CJ NA C Corp Texas Health Biomedical Advancement Cent 612 E Lamar Blvd Arlington TX 76011 752636884 Research TX NA C Corp THR Primary Care Ext Physcian Network 612 E Lamar Blvd Arlington TX 76011 465365421 Inactive TX NA C Corp false false true false false false false false false true true false true false false true true true true See Part VII for Explanation Schedule R, Part V, Line 2 - Related Transactions Texas Health Resources (THR) is the parent organization of a large healthcare system made up of both wholly owned entities as well as related controlled joint ventures as listed on Schedule R. THR's role is to plan, manage and coordinate the activities of the affiliated healthcare system in order to maximize opportunities to deliver cost effective quality medical care to residents of north central Texas. THR provides direction and oversight to its wholly owned affiliates through centralized services. They also provide oversight for the controlled joint ventures. As an integral part of providing centralized services to the affiliates, THR maintains intercompany receivable/payable accounts, most of which do not fall within the scope of IRC Section 512(b)(13). The range of centralized services provided by THR include information services, managed care contracting, Human resources, revenue cycle, billing and collections, patient access/admissions, legal, tax, compliance, supply chain, quality, business development, insurance, treasury, marketing, general accounting, real estate services, coding, transcription and strategic planning. In addition, THR does daily cash sweeps of all controlled tax exempt entity cash accounts. As a result, THR has numerous daily transactions with controlled tax exempt entities, none of which fall within the scope of IRC Section 512(b)(13). A management fee is charged for the centralized services and reported on Form 990, Part VII, Section B as a professional services fee. Transactions with related tax exempt organizations falling within the meaning of centralized services as described above, are not listed on Schedule R, Part V, Line 2.